Thomas Kennie, æt. 30, labourer. Admitted on 10th day of fever: attack commenced, besides the ordinary symptoms, with tenderness of abdomen: at present the abdomen, which is generally tender, is exceedingly so over the right iliac region; bowels stated to be regular; tongue foul, red and dry; thirst; some pain of chest on full inspiration and coughing; cough troublesome; respiration hurried; little sleep; mind confused; face flushed; pulse 120, weak.
11th. Tenderness of abdomen continues; five stools; respiration hurried, with occasional cough and viscid expectoration; slight pain of head; mind distinct; eyes suffused; skin cool, covered with petechiæ. Died next day.
Abdomen. Mucous membrane of small intestines very vascular, that of ilium intensely so; contained several oval and deep ulcers, one of which had perforated the peritoneum, the aperture of which was sufficiently large to allow the apex of the ring finger to pass through it; the peritoneal cavity contained about a pint of pus; the intestines were all glued together; the surface of the liver was very dark and much inflamed. Head. Membranes of brain vascular; substance rather vascular; more fluid than natural in the ventricles. Thorax. Viscera healthy.
Case LXXXVIII.
David Piggott, æt. 19, furrier. Admitted on the 9th day of fever: at present, severe pain in the right hypochondrium, stretching towards the umbilicus, increased on pressure; tongue brown and dry; no stool; slight cough; some pain of head; eyes suffused; pulse 108, firm. V.S. ad ℥x.
10th. Pain of right hypochondrium gone; tongue the same; no pain of head; very deaf; slept tolerably; pulse 100, soft.
11th. No pain; tongue unchanged; one copious stool, consisting chiefly of blood; slept well; mind confused; countenance rather improved; pulse 96.
12th. No pain; two stools, with less admixture of blood; mind distinct; pulse 110.
13th. Eight stools, scanty, without blood; tongue dry and furred; slept ill; great prostration; pulse 90. Died next day.
Abdomen. Mucous membrane of small intestines in general vascular, especially that of the ilium and commencement of the colon, in both of which were numerous ulcerations; one in the former had perforated the bowel, forming a hole of the size of a sixpence; about a quart of sero-purulent fluid in the peritoneal cavity; the intestines were glued together, and their peritoneal coat generally inflamed. Head. Membranes of brain vascular; substance natural. Thorax. Viscera healthy.